The Guest Care at Spring Lake, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

869 Issued in LA

Legal business name

THE GUEST CARE AT SPRING LAKE, LLC

Practice address

8622 Line Ave
Shreveport, LA 71106-6108

Phone

(318) 868-4126

Fax

(318) 868-9084

NPI assigned

Jun 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kevin C Gamble

Title

Officer

Phone

(318) 798-2648

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282867200000",
    "number": "1609818046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52389",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711352389",
            "telephone_number": "318-798-2648",
            "fax_number": "318-798-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8622 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066108",
            "telephone_number": "318-868-4126",
            "fax_number": "318-868-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GUEST CARE AT SPRING LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2010-08-27",
        "status": "A",
        "authorized_official_last_name": "GAMBLE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "318-798-2648",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517551",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Edge Physical Therapy and Sports Science Center
• The Glen Retirement System (Glen Oaks Retirement Home)
• The Glen Retirement System
• The Glen Retirement System (Village Health Care)
• The Golden Center LLC
• The Guest House LLC
• The Healing Clinic, LLC
• The Intensivist Group, LLC
• The Joyful Mind Counseling and Wellness
• The Joyful Mind Counseling and Wellness

• Skilled Nursing Facility in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.